Objectives: Little is known about how different fall-based injuries relate to fear of falling and activity restriction, and if these relationships differ between sexes. We explored fear of falling and activity restriction in individuals who have experienced fall-based injuries. Methods: A total of 16,369 older adults from the Canadian Community Health Survey reported their worst fall-based injury, whether they experience fear of falling, and whether they restrict activities from fear of falling. Results: Females had greater odds of fear of falling than males. Only females who experienced a fracture or head injury had increased odds of fear of falling and only females who experienced a head injury had increased odds of restricting activities compared with females who fell without injury. Discussion: Only severe fall-based injuries are associated with fear of falling and activity restriction, and this relationship is unique to females. Sex differences warrant further investigation and suggest a need for targeted interventions.